【摘要】 目的探讨术中超声(IOUS)引导门静脉穿刺肝段染色在肝癌切除术中的应用价值。方法术中超声引导下分别对两组肝癌患者行肝切除术,其中染色组50例,超声引导行门静脉穿刺肝段染色规则性肝段切除术;对照组30例,术中超声定位行常规肝切除术,并对两组患者手术所用时间、术中出血量、并发症发生率及术后肝癌的复发率进行分析比较。结果 (1)染色组50例中46例(92.0%)肝段染色成功,拟切除肝段整体着色,与相邻肝段界限清晰,指导临床顺利完成了规则性肝段切除手术;对照组30例术中超声引导下行常规肝切除手术。(2)染色组术中平均出血量(529.35±155.11)ml少于对照组(676.67±264.81)ml。(3)染色组术后严重并发症发生率(8.7%,4/46)、术后1年肝癌复发率(10.9%,4/50)均低于对照组(30.0%,9/30)、(30.0%,9/30)。(4)两组患者术中平均出血量、术后严重并发症发生率及术后1年肝癌复发率比较差异均有统计学意义(P<0.05)。结论术中超声引导门静脉穿刺肝段染色指导肝癌切除手术成功率高,规则性肝段切除可有效保存剩余肝脏功能,减少并发症发生,降低肝癌术后复发率,延长患者无瘤生存时间。更多还原

【Abstract】 Objective To explore the clinical value of intraoperative ultrasound (IOUS) guided segmental staining for the hepatectomy of liver cancer. Methods Fifty patients took hepatic segmentectomy under segmental staining by IOUS(staining group), thirty patients received routine hepatectomy(control group) and the operating time, bleeding volume and the complication were compared between the two groups. Seventy-six patients were followed up, and the rate of recurrence was compared between the two groups. Results The successful rate of segmental staining was 92.0%(46/50) in staining group. The average blecding volume were 529.35±155.11 ml and 676.67±264.81 ml (P<0.05), the serious complication rate was 8.7% and 30.0% (P<0.05), the 1-year recurrent rate after hepatectomy was 10.9% and 30.0% (P<0.05) between staining groups and control group, respectively. Conclusion The successful rate of IOUS guided hepatic segmental staining is high. The precise and complete hepatic segmentectomy may conserve surplus liver function, reduce postoperative complications, lower postoperative relapse rates and improve disease free survival time.更多还原